A second ultrasound was done at 22 weeks with femur length at the 5th percentile.

At the end of 32 weeks, bilateral femoral hypoplasia was seen with femoral bowing. The examination was technically difficult, but we observed theses anomalies:

Bilateral femoral hypoplasia < 3th percentile (image 1,2)

Image 1,2:

Tibia and fibula = 5th percentile (Image 3)

Image 3:

Poor visualization of the spine

Bilateral club feet

Allantoic cyst of the umbilical cord (Image 4)

Image 4:

The bones of the upper limbs were normal in length

The facial profile seemed normal appearance

The anus appeared to be present

A spiral CT was performed at 32 weeks. We confirmed bilateral femoral hypoplasia with short tibias and fibulae, dislocation of the upper end of the femur, bilateral club foot , partial agenesis sacral vertebral bodies (Image 5-9).Image 5-9:

Because of the poorly controlled diabetes and bilateral femoral hypoplasia with dislocated hips suggested a teratologic etiology, we suspected bilateral femoral hypoplasia. The femoral-facial syndrome was considered unlikely because of the normal facial profile.

The patient met the pediatric surgeon and continued the pregnancy.The child was born at 37 weeks (third cesarean section). Bone abnormalities were confirmed (Image 10,11).